Provider Demographics
NPI:1013640101
Name:FLANAGAN, ANNE MARIE (RD/LD)
Entity Type:Individual
Prefix:
First Name:ANNE MARIE
Middle Name:
Last Name:FLANAGAN
Suffix:
Gender:F
Credentials:RD/LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 N SHARTEL AVE STE 409
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103-2400
Mailing Address - Country:US
Mailing Address - Phone:405-702-6770
Mailing Address - Fax:405-702-6331
Practice Address - Street 1:1211 N SHARTEL AVE STE 409
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-2400
Practice Address - Country:US
Practice Address - Phone:405-702-6770
Practice Address - Fax:405-702-6331
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1465133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered